Hospital Stays Often Cause Decline for People with Alzheimer's
“Get your hands off me, you big oaf,” Mom demanded. No, she wasn’t talking to my father. In this case, she was talking to a nurse who had come into her hospital room to help reposition her to be more comfortable. But because of Alzheimer’s disease, Mom didn’t understand what the nurse was doing. Mom had been admitted to the hospital a few days earlier because she was suffering from a respiratory infection that was threatening to become pneumonia. This was a very serious situation since Mom also had Chronic Obstructive Pulmonary Disease (COPD), which already had robbed her of approximately 80 percent of her lung capacity. Thanks to the hospital staff’s care, Mom started to improve and soon was discharged to return to the nursing home. But only a few days later, Mom started declining mentally and died within 10 days of her hospitalization.
It turns out that some sort of decline – whether mental or mortal – is often seen once people with Alzheimer’s disease leave the hospital. In fact, a new study out of Harvard University has found that hospitalizations seem to increase the chance that people with Alzheimer’s will decline – meaning cognitive decline, being put in a nursing home, or dying – within the following year.
“Evidence has shown that older patients with Alzheimer’s disease (AD) are much more likely to be hospitalized than other older patients,” said lead author Tamara Fong, MD, PhD, assistant scientist in the Aging Brain Center, Institute for Aging Research at Hebrew SeniorLife and Assistant Professor of Neurology at Beth Israel Deaconess Medical Center. “Because our previous research had found that AD patients experienced a three times faster decline in mental function if they had experienced delirium, we wanted to determine if AD patients who are hospitalized are at greater risk for poor outcomes than AD patients who are not hospitalized, and if there is any additive negative outcome when hospitalized AD patients develop delirium.”
The researchers analyzed records of 771 patients who were over the age of 65 and who were examined between 1991 and 2006 at the Massachusetts Alzheimer’s Disease Registry, based at Massachusetts General Hospital. Their analysis focused on patients who had been hospitalized as well as those who had not. All of these patients had all been seen at least three times at the registry. The researchers found that any hospitalization of people with Alzheimer’s was associated with increased risk for institutionalization, cognitive decline and death. Furthermore, patients who developed delirium had an incremental increased risk for institutionalization, cognitive decline and death.
“The experience (of being hospitalized) can be especially traumatic for a person with Alzheimer’s disease or another dementia,” the Alzheimer’s Association stated. “The change from home to an unfamiliar environment and the added stress caused by other medical treatments and possibly pain are likely to make the person more confused and disoriented than usual.”
The Harvard researchers cautioned that caregivers need to be aware that their loved one with dementia will face added risk if hospitalized. The Alzheimer’s Association encourages caregivers to talk to doctors about avoiding unnecessary hospitalizations. The association recommends the following:
- See if the procedure, test or treatment can be performed in an outpatient clinic.
- Find out how long the loved one with dementia will need to be hospitalized, if needed.
- Determine if tests can be done prior to admission in order to shorten the love one’s stay in the hospital.
- If the doctor plans to consult with other physicians, ask if the consulting physicians can see the loved one prior to hospitalization.
Primary Sources for This Sharepost:
Alzheimer’s Association. (2007). Hospitalization.
Institute for Aging Research. (2012). Findings show that Alzheimer’s patients experience adverse outcomes following hospitalization, delirium